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General NPI Number Information
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NPI Number | 1134911647
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Entity Type | Individual
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Provider Name | SAMANTHA LINA YANCY DDS
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 07/20/2025
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Provider Practice Location Address
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Address Line | 8472 SIMMOND ST
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City | FORT GEORGE G MEADE
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State | MD
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Zip | 20755-5700
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Country | US
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Telephone | 301-677-6983
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Fax |
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Provider Business Mailing Address
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Address Line | N8402 STATE HIGHWAY 42
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City | SHEBOYGAN
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State | WI
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Zip | 53083-5221
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Country | US
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Telephone | 920-980-7234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 600178615
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License Number State | WI
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